Associate Health Care Management Systems Analyst - 60206

at  Health Department of

Current NYS Department of Health (DOH) employee with permanent or contingent-permanent, competitive status as an Associate Health Care MSA, G-23 OR a NYS employee with one year or more of permanent or contingent-permanent, competitive service in a title at or above a G-21 and deemed eligible for transfer to Associate Health Care MSA, G-23 under section 52.6 of the NYS Civil Service Law.
Open to the Public: This title is part of the New York Hiring for Emergency Limited Placement Statewide program (NY HELPS). For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, if the candidate meets the below NY HELPS minimum qualifications.
NY HELPS Non-Competitive Minimum Qualifications:
A bachelor’s degree in accounting, business administration, economics, finance, health care administration, health policy, health systems, or public administration; and three years of specialized experience in either evaluation of programs in the health care financing field or in health services research in finance, design, or implementation and one year of which must include experience in conducting public policy research and analysis in finance.
Preferred Qualifications: Professional work experience should include knowledge of Medicaid policy and rate setting. Strong critical thinking skills, strong analytical skills, experience with Microsoft Excel, ability to solve problems independently. The candidate should have knowledge of the NYS Medicaid program and have the ability to interact and collaborate with other Medicaid-related State Agencies, as well as the Division of the Budget and Centers for Medicare & Medicaid Services.

The Office of Health Insurance Programs (OHIP) is responsible for operating the State’s Medicaid program, which provides coverage to over 7.5 million members and totals over $100 billion in annual expenditures. The Division of Finance and Rate Setting (DFRS) is responsible for all functions within OHIP related to rate setting, including fee for service and managed care rates. This division has full oversight of the Medicaid budget, is the liaison with the Division of Budget, and manages the Medicaid Global Spending Cap. Within DFRS, the Bureau of Nursing Home and Long Term Care Rate Setting consists of four teams that conduct rate setting, cost analysis, and other activities for public and private nursing homes and a range of long term care facilities and support services. The Associate Health Care Management Systems Analyst will lead the Upper Payment Limit (UPL) unit within the Nursing Home Operating team. Duties include: Draft, revise, and coordinate the annual Nursing Facility UPL demonstration submission and associated State Plan amendments and communications with providers, Federal CMS, etc., Review State and federal health care statutes, regulations, and policies for their impact on Medicaid Fee for Service nursing home programs and associated financing mechanisms, Analyze and review rate packages for annual and supplemental Fee for Service rates, Conduct reviews related to rate appeals, OMIG audits, and litigation, Participate in the collection and analysis of nursing home cost report data and case mix data, Conduct surveys, studies, and health care modeling activities to analyze health care systems and validate health care financing and utilization information, Draft reports, policies, and procedures for internal and external review and distribution, Respond to requests for information or data from providers, associations, other DOH divisions, etc., Supervise one to three G-18s (Senior Health Care Management System Analyst or comparable title) in the completion of similar tasks